PACIFIC HEAVEN RES. CARE FACILITY FOR THE ELDERLY

16301 MAGELLAN LANE, Huntington Beach CA 92647

Facility 306003054 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Oct 21, 2025Licensed

Additional info
Licensee
BURGOS, WILLIAM & BETTY
Administrator
BETTY BURGOS
Contact
BETTY BURGOS
License first date
Oct 18, 2005
License effective date
Oct 18, 2005
District office
ORANGE COUNTY RO · (714) 703-2840
Regional office
22
Clients served
985 - RCFE / HOSPICE

Summary

The available records show 2 Type A and 3 Type B deficiencies for this facility.

Most recent inspection
Oct 21, 2025
Most recent deficiency
Oct 21, 2025

No later report is available, so the records do not show what happened afterward.

What Type A and Type B mean
Type A
Violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
Type B
Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.

Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.

At a glance

Counts cover the five-year public record. Typical figures are the median for the 984 Orange County facilities licensed for 6 or fewer beds.

In the available public five-year record, CCLD published 4 reports for this facility: 4 inspections, 0 complaint investigations, and 0 licensing or administrative records.

Those records contain 2 Type A and 3 Type B deficiencies.

0 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
4

About the same as most this size

1 in the last 12 months

Recorded deficiencies
5

More than the typical 1

5 in the last 12 months

Type A deficiencies
2

Most this size have none

2 in the last 12 months

Type B deficiencies
3

More than the typical 1

3 in the last 12 months

Substantiated complaints
0

Most this size also have none

0 in the last 12 months

Repeated topics
0

Last 36 months

Repeated topics

Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.

No topic repeats in the last 36 months

No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.

Official report history

All preserved reports from the most recent to the oldest, sortable by report type.

Inspection
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(f)
Regulation authority
CCR

What the official deficiency says

(f) All personnel, including the licensee and administrator, shall be in good health, and physically and mentally capable of performing assigned tasks. Good physical health shall be verified by a health screening, including a chest x-ray or an intradermal test, performed by a physician not more than six (6) months prior to or seven (7) days after employment or licensure. A report shall be made of each screening, signed by the examining physician. The report shall indicate whether the person is physically qualified to perform the duties to be assigned, and whether he/she has any health condition that would create a hazard to him/herself, other staff members or residents. A signed statement shall be obtained from each volunteer affirming that he/she is in good health.Personnel with evidence of physical illness or emotional instability that poses a significant threat to the well-being of residents shall be relieved of their duties. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed , the licensee did not comply with the section cited above in 1 out of 3 employee as Staff 1 did not have a health screening on record. This poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/29/2025 Plan of Correction Faciltiy agreed to obtain a health screeining LIC 501 and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Fire safety and emergency preparednessType B
Official classification
Type B
Official code
1569.695(c)
Regulation authority
HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the cited above as there is no documentation of emergency drills. This poses a potential risks to persons in care.

Official plan of correction

POC Due Date: 10/29/2025 Plan of Correction Facility to conduct emergency drill and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
1569.625(b)(2)
Regulation authority
HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on records reviewed the licensee did not comply with the cited above in 2 out of 2 employees as there are not training records on file. This poses a potential risk to health and safety to persons in care.

Official plan of correction

POC Due Date: 10/31/2025 Plan of Correction Facility agrees to conduct training and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Health conditions and treatmentsType A
Official classification
Type A
Official code
87608(a)(3)
Regulation authority
CCR

What the official deficiency says

(a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions.(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order. This requirement is not met as evidenced by: Deficient Practice Statement Based on observations and records reviewed the licensee did not comply with the cited above in 6 out of 6 residents as no rail orders were on file for residents. This poses an immediate health and safety risks to persons in care.

Official plan of correction

POC Due Date: 10/29/2025 Plan of Correction Faciltiy removed rails from all residents beds and will obtain physician orders for half rails only and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Fire safety and emergency preparednessType A
Official classification
Type A
Official code
87203
Regulation authority
CCR

What the official deficiency says

All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic. This requirement is not met as evidenced by: Deficient Practice Statement Based on observation the licensee did not comply with the cited above in 3 out of 4 bedrooms as the smoke detectors were not operational. This poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 10/22/2025 Plan of Correction Facility agreed to replace all non operational smoke detectors and provide proof to LPA by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report

Source and limits

California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.

Read the data methodology